Canadian English Language Benchmark Assessment for Nurses (CELBAN) — Questions and Answers

Question 1: A nurse is speaking with an elderly patient who is hard of hearing. Which communication strategy is most appropriate for the CELBAN Speaking scenario?

Speak as fast as possible to save time.
Ask a family member to relay all information to the patient.
Shout loudly to ensure the patient hears every word.
Face the patient, speak clearly, and use simple sentences at a moderate pace. (Correct answer)

Correct answer: Face the patient, speak clearly, and use simple sentences at a moderate pace.

Facing the patient, speaking clearly and slowly, and using plain language are best practices for communicating with hearing-impaired patients.

Question 2: Which phrase is an example of using inclusive and person-first language with a patient who has a disability?

'The patient in Room 4 who uses a wheelchair needs assistance' (Correct answer)
'The wheelchair-bound patient needs assistance'
'The handicapped individual in Room 4 requires support'
'The disabled patient in Room 4 needs assistance'

Correct answer: 'The patient in Room 4 who uses a wheelchair needs assistance'

Person-first language identifies the individual before the condition, acknowledging personhood rather than defining someone by their disability.

Question 3: In a dialogue, a patient tells the nurse, 'My head is pounding, the lights are bothering my eyes, and I feel like I'm going to be sick.' Which of the following is the most accurate summary of the patient's primary symptoms?

General fatigue and dizziness.
Headache, photosensitivity, and nausea. (Correct answer)
Blurred vision and stomach cramps.
Nausea and fever.

Correct answer: Headache, photosensitivity, and nausea.

The patient's statements directly correspond to the medical terms for the symptoms listed. 'My head is pounding' is a headache, 'the lights are bothering my eyes' is photosensitivity, and 'I feel like I'm going to be sick' indicates nausea. The other options include symptoms not mentioned by the patient.

Question 4: In a CELBAN speaking task simulating a triage scenario, a patient describes chest pain that started 20 minutes ago. What is the most important verbal action the nurse should take first?

Tell the patient to wait in the waiting room until their name is called.
Ask the patient to complete a paper triage form.
Offer the patient a glass of water and reassure them it is probably heartburn.
Immediately notify the charge nurse or physician while keeping the patient calm and asking them to remain seated. (Correct answer)

Correct answer: Immediately notify the charge nurse or physician while keeping the patient calm and asking them to remain seated.

Acute chest pain is a potential cardiac emergency requiring immediate escalation while keeping the patient calm and stationary.

Question 5: While monitoring a shared room, a nurse hears one patient whisper to another: 'I heard the nurses say my test came back bad but nobody's told me officially yet.' What is the most appropriate nursing action?

Notify the responsible physician so the patient can receive a proper explanation (Correct answer)
Inform the patient that overheard conversations may be inaccurate
Document that the patient is spreading rumors among peers
Confirm or deny the test result immediately to reduce anxiety

Correct answer: Notify the responsible physician so the patient can receive a proper explanation

Results should be communicated by the responsible provider; the nurse's role is to escalate so the patient receives accurate, timely information.

Question 6: You are a nurse who witnessed a visitor slip and fall on a wet floor in the hospital hallway. The visitor states they are not injured, but you insist on completing an incident report. What is the primary purpose of writing this report?

To create a record to protect the visitor in a future lawsuit.
To document the event for risk management and quality improvement. (Correct answer)
To ensure the visitor receives a bill for the assessment.
To discipline the cleaning staff responsible for the wet floor.

Correct answer: To document the event for risk management and quality improvement.

The main purpose of an incident report is to serve as a tool for the healthcare organization to track and analyze events for risk management, identify patterns, and implement changes to improve safety and quality of care. It is not primarily for billing, discipline, or legal action for the injured party.

Question 7: A shift handover report reads: 'Mr. Chen in Room 14 is post-op day 2 following bowel resection. He has a nasogastric tube to low intermittent suction, is NPO, and receiving TPN. His abdomen remains distended and he has not passed flatus.' What does 'not passed flatus' indicate in this context?

The nasogastric tube is incorrectly placed and needs repositioning
Postoperative ileus may be present as bowel motility has not returned (Correct answer)
TPN is causing bloating and should be discontinued
The patient's bowel sounds are absent, requiring urgent intervention

Correct answer: Postoperative ileus may be present as bowel motility has not returned

Absence of flatus after bowel resection suggests postoperative ileus — the bowel has not yet regained peristaltic function.

Question 8: In a CELBAN Speaking role-play involving a confused post-operative patient who is trying to get out of bed unsafely, which response best balances safety and communication?

Physically restrain the patient immediately without speaking.
'If you get up, I'll have to call security.'
Calmly approach, make eye contact, and say: 'I'm your nurse. You've just had surgery. I need you to stay in bed right now so you don't fall. I'll help you.' (Correct answer)
Leave to get help without saying anything to the patient.

Correct answer: Calmly approach, make eye contact, and say: 'I'm your nurse. You've just had surgery. I need you to stay in bed right now so you don't fall. I'll help you.'

Calmly reorienting the patient, stating the reason for staying in bed, and offering assistance addresses both safety and communication needs.

Question 9: A patient's chart allergy section lists: 'PCN — Anaphylaxis.' Which antibiotic should the nurse question before administration?

Ampicillin (Correct answer)
Ciprofloxacin
Vancomycin
Azithromycin

Correct answer: Ampicillin

Ampicillin is a penicillin-class antibiotic (PCN), and administering it to a patient with a documented PCN anaphylaxis allergy would be dangerous.

Question 10: A patient receiving blood thinner injections at home asks, 'What do I do if I miss a dose?' What is the most appropriate nursing response?

'Contact your healthcare provider for guidance.' (Correct answer)
'Take a double dose to make up for it.'
'Stop the medication and return to hospital.'
'Do not take the missed dose; skip it and resume your normal schedule.'

Correct answer: 'Contact your healthcare provider for guidance.'

Missed anticoagulant dose guidance depends on the specific drug and patient factors, so the healthcare provider must be consulted.

Question 11: During a CELBAN speaking task simulating a handover report, which information should a nurse prioritize communicating to the incoming nurse?

A detailed history of the patient's previous hospitalizations
The patient's meal preferences and visiting hours
The nurse's personal opinion about the patient's behavior
Current status, recent changes, pending tasks, and safety concerns (Correct answer)

Correct answer: Current status, recent changes, pending tasks, and safety concerns

An effective handover report focuses on current clinical status, significant changes, outstanding tasks, and any safety concerns.

Question 12: In a CELBAN speaking role-play, a patient becomes upset and says, 'No one ever listens to me!' What is the best immediate response?

'Please calm down so we can talk properly.'
'I listen to all my patients equally.'
'I understand you feel unheard. I'm here now and I want to listen to you.' (Correct answer)
'Let me get the charge nurse to speak with you.'

Correct answer: 'I understand you feel unheard. I'm here now and I want to listen to you.'

Validating the patient's feelings and expressing willingness to listen de-escalates the situation and demonstrates empathic communication.

Question 13: A patient with a new pacemaker is being discharged. Which instruction is INCORRECT and must be corrected?

Carry a pacemaker identification card at all times
You can safely use a microwave oven without any concern (Correct answer)
Avoid strong magnetic fields such as MRI scanners
Hold a cell phone on the opposite side from the pacemaker

Correct answer: You can safely use a microwave oven without any concern

Although modern pacemakers are generally safe around microwaves, patients must be individually counselled based on their device manufacturer's guidelines, so blanket reassurance without qualification is inappropriate.

Question 14: "I apologize, but it appears that I am unclear. Would you kindly clarify your problem for me again?"

Set appropriate expectations
Revalidation phrase (Correct answer)
Probing question
Examples of clarifying questions are:

Correct answer: Revalidation phrase

Apologizing for being unclear and asking the patient to re-explain their problem is a revalidation phrase, used to confirm or correct your understanding of what was communicated. It is not a probing or clarifying question, both of which gather new information rather than re-confirming existing information.

Question 15: A chart note reads: 'Patient refuses blood transfusion on religious grounds. Patient is alert, oriented x3, and has demonstrated understanding of the risks including death from continued blood loss. Patient has signed a refusal of treatment form.' A family member demands the nurse give the blood anyway. What is the ethically and legally correct response?

Uphold the patient's documented informed refusal; the patient is competent to decide (Correct answer)
Honor the family's wishes since they have the patient's best interest in mind
Administer the blood since preventing death overrides patient choice in this situation
Call security to remove the family and then give the blood

Correct answer: Uphold the patient's documented informed refusal; the patient is competent to decide

A competent adult patient has the right to refuse any treatment, including life-saving blood transfusions; the documented informed refusal must be respected.

Question 16: Steer clear of: Cold greetings without feeling

"Hi, I'm Toni your nurse for today. You can call me anytime you need help" (Correct answer)
"In this case, time is of the essence. I am going to speak with Dr. Brown or my Nurse Supervisor to help me expedite this issue."
Level setting of expectations with empathy
You can also ask probing questions that will help you obtain more information such as:

Correct answer: "Hi, I'm Toni your nurse for today. You can call me anytime you need help"

The correct answer demonstrates a warm, personal greeting by introducing the nurse by name and offering open availability, which immediately builds rapport and trust with the patient. The other options either set expectations without warmth, escalate an issue, or describe a questioning technique — none of which qualify as a greeting at all.

Question 17: A nurse is instructing a patient who has a new diagnosis of diabetes. Which statement is the clearest and most effective instruction regarding hypoglycemia?

"You need to be aware of the potential for hypoglycemic episodes and manage your glucose levels proactively."
"Low blood sugar, or hypoglycemia, is a serious risk. You must monitor your blood sugar to prevent a hyperglycemic rebound."
"Your diet and insulin must be balanced to avoid dysglycemia. Call your endocrinologist if you notice any abnormalities."
"If you feel shaky, dizzy, or sweaty, check your blood sugar. If it's low, drink a small glass of juice or eat some hard candy." (Correct answer)

Correct answer: "If you feel shaky, dizzy, or sweaty, check your blood sugar. If it's low, drink a small glass of juice or eat some hard candy."

This answer is the most effective because it avoids medical jargon, links specific, easy-to-recognize symptoms (shaky, dizzy, sweaty) to a clear action (check blood sugar), and provides a simple, immediate solution (drink juice or eat candy).

Question 18: The physician's order in a chart reads: 'Elevate HOB 30 degrees.' What does HOB stand for?

Horizontal of Baseline
Heart of Bed
Height of Body
Head of Bed (Correct answer)

Correct answer: Head of Bed

HOB is a standard nursing abbreviation for Head of Bed, and elevating it 30 degrees is commonly ordered to prevent aspiration and reduce ICP.

Question 19: A nurse says, "Please inform me if you feel dizzy after taking the medication." What should the patient do?

Only inform the nurse if dizziness occurs. (Correct answer)
Take the medication only if dizziness is felt
Avoid taking the medication.
Inform the nurse immediately after taking the medication.

Correct answer: Only inform the nurse if dizziness occurs.

The nurse's instruction, "Please inform me if you feel dizzy after taking the medication," uses the conditional word "if." This means the patient should only report to the nurse in the specific event that dizziness is experienced, not as a routine action.

Question 20: A passage about therapeutic communication reads: 'Therapeutic communication techniques include active listening, open-ended questions, silence, and clarification. Non-therapeutic techniques such as false reassurance, giving advice, and changing the subject can hinder the nurse-patient relationship.' A patient says: 'I'm terrified about my surgery tomorrow.' The nurse responds: 'Don't worry — everything will be just fine!' What technique does this represent?

Clarification
Active listening
False reassurance (Correct answer)
Open-ended questioning

Correct answer: False reassurance

Telling a patient not to worry and that everything will be fine dismisses their feelings and offers unfounded guarantees — a classic example of false reassurance.

Question 21: A patient newly diagnosed with Type 2 diabetes tells her husband during your assessment: 'I guess I just have to give up everything I enjoy eating.' What does this statement suggest to the nurse?

The patient is in denial and not ready to engage with her care plan
The patient's cultural food preferences conflict with medical guidelines
The patient holds a misconception about diabetes management that requires education (Correct answer)
The patient has already received thorough dietary counseling

Correct answer: The patient holds a misconception about diabetes management that requires education

The patient's all-or-nothing thinking suggests a misconception; a dietitian referral and education about balanced meal planning are indicated.

Question 22: A chart shows: 'Foley catheter inserted 3 days ago, urine output 20 mL/hr for last 2 hours.' What should the nurse do?

Increase IV fluid rate immediately without notifying the physician
Assess the catheter for obstruction and notify the physician of low urine output (Correct answer)
Remove the catheter and allow the patient to void naturally
Document the finding and reassess in 4 hours

Correct answer: Assess the catheter for obstruction and notify the physician of low urine output

Normal adult urine output is at least 30 mL/hr; 20 mL/hr for two consecutive hours indicates oliguria requiring assessment for catheter obstruction and physician notification.

Question 23: A CELBAN listening passage describes a nurse saying: 'I noticed the patient's wound drainage has changed from serous to seropurulent over the past 24 hours, and there's some surrounding erythema.' What change is being described?

The wound drainage has changed from clear/straw-coloured to cloudy with pus, and redness has appeared around the wound, suggesting possible infection (Correct answer)
The patient's wound is fully closed and no further monitoring is needed
The wound is healing faster than expected with no concerns
The wound dressing needs to be changed to a waterproof type

Correct answer: The wound drainage has changed from clear/straw-coloured to cloudy with pus, and redness has appeared around the wound, suggesting possible infection

Seropurulent drainage (cloudy, mixed with pus) replacing serous drainage, combined with erythema, are classic early signs of wound infection requiring prompt assessment.

Question 24: Which of the following is the most appropriate closing statement in a verbal handover report?

I'm too tired to say more — the rest is standard.
Do you have any questions or anything you'd like me to clarify before I leave? (Correct answer)
That's all I know. Good luck.
You can read the rest in the chart.

Correct answer: Do you have any questions or anything you'd like me to clarify before I leave?

Inviting questions at the end of handover ensures the incoming nurse has full understanding and promotes safe care transitions.

Question 25: A nurse listening to a recorded nursing lecture hears: 'When assessing pain, remember the mnemonic OLDCART — Onset, Location, Duration, Character, Aggravating factors, Relieving factors, and Treatment.' Which component is captured by the letter 'C'?

Circulation — blood flow to the affected area
Character — the quality or nature of the pain, such as burning, stabbing, or aching (Correct answer)
Consent — patient agreement to pain assessment
Complications — associated signs and symptoms

Correct answer: Character — the quality or nature of the pain, such as burning, stabbing, or aching

In OLDCART, 'C' stands for Character, which describes the quality of pain (e.g., sharp, dull, burning, throbbing).

Question 26: A nurse overhears two nurses at the station discussing a patient's HIV status by name in front of visitors in the hallway. What is the immediate concern?

The nurses may have incorrect information about the patient's diagnosis
The conversation should be allowed to continue if it is clinically relevant
This is a breach of patient confidentiality and privacy that must be addressed immediately (Correct answer)
The visitors likely do not understand medical terminology, so no harm has occurred

Correct answer: This is a breach of patient confidentiality and privacy that must be addressed immediately

Discussing a patient's sensitive diagnosis by name in a public area violates confidentiality and must be stopped and addressed according to facility policy.

Question 27: A patient says, "I feel short of breath when I walk upstairs." What is the patient experiencing?

Chest pain.
Dizziness.
Fatigue.
Difficulty breathing. (Correct answer)

Correct answer: Difficulty breathing.

To feel "short of breath" is a common medical term for dyspnea, which describes the sensation of having difficulty breathing or not being able to get enough air. This symptom is often exacerbated by physical exertion, such as walking upstairs. Thus, the patient is experiencing difficulty breathing.

Question 28: A nurse hears a patient on the phone say: 'They want me to go home tomorrow but I live alone and I'm still so weak — I'm scared.' What is the nurse's best next step?

Reassure the patient that discharge criteria are medically determined
Notify the care team and initiate a discharge planning discussion including social work (Correct answer)
Advise the patient to ask a family member to move in temporarily
Extend the patient's stay by one day without consulting the physician

Correct answer: Notify the care team and initiate a discharge planning discussion including social work

The patient's concern about safety at home is a discharge planning issue requiring multidisciplinary input, including social work.

Question 29: A patient is ordered 'oral rehydration therapy.' Which intervention does this involve?

Restricting fluid consumption
Providing tube feeding
Encouraging fluid intake by mouth (Correct answer)
Administering IV fluids through a catheter

Correct answer: Encouraging fluid intake by mouth

Oral rehydration therapy involves giving fluids and electrolytes by mouth to treat or prevent dehydration.

Question 30: While documenting social history, which question best screens for intimate partner violence?

Is your home environment safe and comfortable?
Do you ever feel afraid of someone at home? (Correct answer)
Who lives with you at home?
Are you in a relationship?

Correct answer: Do you ever feel afraid of someone at home?

Asking if the patient ever feels afraid of someone at home is a validated, direct screening question for intimate partner violence that is sensitive yet clinically effective.

Question 31: Which question uses the most therapeutic open-ended technique when beginning a patient history?

Do you have any chest pain today?
Is your pain sharp or dull?
Have you had this problem before?
What brings you in to see us today? (Correct answer)

Correct answer: What brings you in to see us today?

'What brings you in today?' is a non-leading open-ended question that allows the patient to describe their chief complaint in their own words.

Question 32: A nurse finds a patient on the floor beside their bed. After assessing the patient and ensuring their immediate safety, the nurse calls the physician. What is the next most appropriate action regarding documentation?

Wait for the supervisor's instructions before writing anything.
Document the factual details of the fall and the physician notification in the patient's chart. (Correct answer)
Make a detailed entry in the patient's chart stating that an incident report was completed.
Complete the facility's incident report form and place a copy in the patient's chart.

Correct answer: Document the factual details of the fall and the physician notification in the patient's chart.

The nurse should document the objective facts of the incident (what was seen, the patient's condition, actions taken) in the patient's medical record. The incident report is a separate, internal administrative tool and reference to it should not be made in the patient's chart.

Question 33: In a patient's chart, the vital signs section reads: 'BP 90/60 mmHg, HR 118 bpm, RR 24, Temp 38.9°C.' Which finding is most immediately concerning?

The low blood pressure combined with high heart rate
The elevated temperature
The combination of all four abnormal findings (Correct answer)
The increased respiratory rate

Correct answer: The combination of all four abnormal findings

All four findings together suggest possible septic shock: hypotension, tachycardia, tachypnea, and fever are classic signs requiring immediate intervention.

Question 34: A CELBAN listening section features a pharmacist counselling a patient: 'This antibiotic needs to be taken with a full glass of water and you should remain upright for at least 30 minutes afterward — it can cause esophageal irritation if you lie down too soon.' Which antibiotic class is most likely being described?

Fluoroquinolones, which should be taken with antacids for best absorption
Bisphosphonates — wait, this is a tetracycline or doxycycline, which causes esophageal irritation when the patient reclines after dosing (Correct answer)
Macrolides, which must always be taken on an empty stomach
Penicillins, which require refrigeration to maintain stability

Correct answer: Bisphosphonates — wait, this is a tetracycline or doxycycline, which causes esophageal irritation when the patient reclines after dosing

The instruction to stay upright for 30 minutes and use a full glass of water is a hallmark counselling point for tetracyclines (especially doxycycline) to prevent pill-induced esophagitis.

Question 35: Which of the following is the most effective strategy when taking the CELBAN Listening test, given that audio clips are played only once?

Focus only on listening and ignore the questions until the audio stops.
Try to write down every single word the speaker says.
Read the questions beforehand and select answers as you hear the relevant information. (Correct answer)
Wait until the entire dialogue is finished before answering any questions.

Correct answer: Read the questions beforehand and select answers as you hear the relevant information.

Because the audio is only played once, it is crucial to multitask. Test-takers are given time to pre-read the questions. This allows them to listen for specific information and select the correct answer as soon as they hear it, which is the most efficient and recommended strategy for the CELBAN Listening section.

Question 36: Globally, the coronavirus infection is beginning to spread in another form. The WHO called the mutation "Omicon," sticking to the Greek letters. Additionally, on November 9th, Botswana received the first report of this virus. Following the eighteen-day period, it was discovered in South Africa and labeled as a "virus of concern." Cases have since been recorded from Israel, Madagascar, Belgium, and Hong Kong. Epidemiologists have cautioned that this new strain may be very contagious and may be able to avoid the defenses provided by our present vaccinations. As a result, several nations have reinstated their restrictions on ravels. In spite of this, the Czech Republic, the UK, and Germany have all effectively reported new cases. Researchers have identified 50 genetic alterations in the DNA that affect the spikes that may make the virus more virulent, more transmissible, and potentially more resistant to vaccinations. These variations are being investigated by scientists in an effort to evaluate the potential risks that Omicron may offer. According to scientists, it can take a few weeks to ascertain how well our vaccinations work against Omicron. "When you've got a virus that's showing this degree of transmissibility, and you're having travel-related cases, it virtually invariably is getting to go everywhere [the world]," the chief medical advisor to the White House has issued a warning. What do current vaccines focus on?

white blood cells
the respiratory system
arms
corona virus spikes (Correct answer)

Correct answer: corona virus spikes

The passage states that the 50 genetic alterations affect the 'spikes' of the virus, and researchers were concerned these changes might make the virus more resistant to current vaccinations, which target those spikes. The respiratory system, arms, and white blood cells are not mentioned as vaccine targets in the passage.

Question 37: A nurse says during handover: 'Mrs. Okafor is due for her 2200 insulin, and her blood glucose at 1800 was 14.2 mmol/L.' Which part of SBAR does this belong to?

Background — past medical history
Recommendation — suggested next steps
Assessment — nurse's clinical judgment
Situation — current issue requiring attention (Correct answer)

Correct answer: Situation — current issue requiring attention

Situation describes the current, immediate clinical status or concern, and upcoming medication with recent lab values constitutes a current situation requiring action.

Question 38: "Would you kindly remember if this had occurred previously?"

Once you have a good understanding of the patient's needs, let them know when they can expect to have their symptoms resolved. This can be as simple as saying:
Examples of clarifying questions are:
You can also ask probing questions that will help you obtain more information such as: (Correct answer)
Better Probing question

Correct answer: You can also ask probing questions that will help you obtain more information such as:

Asking 'Would you kindly remember if this had occurred previously?' is a probing question because it digs deeper into the patient's history to gather more relevant details about their condition. Probing questions go beyond surface-level facts to uncover context, unlike clarifying questions which resolve misunderstandings or expectation-setting statements.

Question 39: A CELBAN listening passage features a dietitian saying: 'Given his stage 3 CKD, I've recommended restricting phosphorus, potassium, and sodium in his diet — he should avoid processed foods, dairy, and bananas.' Which condition drives these restrictions?

Type 2 diabetes requiring carbohydrate restriction
Heart failure requiring strict fluid restriction only
A newly diagnosed peanut allergy
Stage 3 chronic kidney disease, which limits the kidneys' ability to excrete electrolytes (Correct answer)

Correct answer: Stage 3 chronic kidney disease, which limits the kidneys' ability to excrete electrolytes

Stage 3 CKD impairs electrolyte excretion, necessitating restrictions on phosphorus, potassium, and sodium to prevent dangerous accumulation.

Question 40: When instructing a patient on wound care at home, what is the FIRST step a nurse should take?

Provide written instructions only
Assess what the patient already knows (Correct answer)
Ask the physician to explain instead
Demonstrate the dressing change

Correct answer: Assess what the patient already knows

Assessing baseline knowledge prevents repetition and allows instructions to be tailored to the patient's needs.

Question 41: During a home care visit, a nurse hears a patient tell a neighbor on the phone: 'I just don't fill those prescriptions — they cost too much and I figure I'll be okay.' What should the nurse assess next?

The extent of the patient's non-adherence, the medications involved, and available drug benefit programs (Correct answer)
Whether the neighbor can help the patient budget for medications
Whether the patient's conditions are serious enough to warrant the cost
Whether the patient qualifies for a different insurance plan

Correct answer: The extent of the patient's non-adherence, the medications involved, and available drug benefit programs

Cost-related non-adherence requires identifying which medications are unfilled, assessing clinical risk, and connecting the patient with drug assistance programs.

Question 42: A discharge teaching handout reads: 'Signs of wound infection include increased redness, warmth, swelling, purulent discharge, and fever above 38°C. Contact your healthcare provider if any of these signs appear within 30 days of surgery.' A patient calls 10 days post-op reporting the wound feels warm and there is yellow drainage. What should the nurse advise?

Contact the healthcare provider as these are signs listed in the handout (Correct answer)
Go directly to the emergency department without calling first
Apply an over-the-counter antibiotic ointment and monitor
Wait another week to see if symptoms resolve on their own

Correct answer: Contact the healthcare provider as these are signs listed in the handout

Warmth and purulent (yellow) drainage within 30 days match the listed infection signs, and the handout instructs patients to contact their provider.

Question 43: A physiotherapist says during an interdisciplinary meeting: 'Mrs. Lam is weight-bearing as tolerated on the right hip — she managed eight metres with the walker this morning but fatigues quickly and needs stand-by assist for safety.' What does this report tell the nursing team?

Mrs. Lam refused physiotherapy and did not attempt walking
Mrs. Lam can walk short distances with a walker but tires easily and still requires a nurse nearby for safety (Correct answer)
Mrs. Lam is fully independent with mobility and needs no nursing support
Mrs. Lam is non-weight-bearing and must remain in bed

Correct answer: Mrs. Lam can walk short distances with a walker but tires easily and still requires a nurse nearby for safety

The physiotherapist reports the patient walked 8 metres with a walker (weight-bearing as tolerated) but fatigues quickly and needs stand-by assistance, meaning nursing supervision is still required.

Question 44: Which speaking strategy helps a CELBAN candidate avoid long, awkward silences when they need a moment to think during a role-play?

Switching topics to something you are more comfortable with
Staring silently at the examiner for up to 30 seconds
Repeating the question word for word three times before answering
Using natural fillers and stalling phrases such as 'That's a great question. Let me make sure I explain this clearly...' (Correct answer)

Correct answer: Using natural fillers and stalling phrases such as 'That's a great question. Let me make sure I explain this clearly...'

Natural stalling phrases maintain conversational flow and demonstrate composure while the speaker formulates a thoughtful clinical response.

Question 45: A nurse receives a telephone call from someone claiming to be a specialist asking for a patient's lab results. The nurse should FIRST:

Verify the caller's identity through an official hospital directory before sharing any information (Correct answer)
Transfer the call to the charge nurse without speaking further
Ask the caller for the patient's date of birth as verification
Provide the results to avoid delaying care

Correct answer: Verify the caller's identity through an official hospital directory before sharing any information

Caller identity must be verified through an independent, official source before disclosing any patient information by telephone.

Question 46: Which language feature is most likely to negatively impact a nurse's CELBAN Speaking score when explaining post-operative care?

Repeating key instructions for emphasis
Pausing briefly to allow the patient to ask questions
Using clear signposting words like 'first,' 'next,' and 'finally'
Heavy use of unexplained medical jargon with a non-medical patient (Correct answer)

Correct answer: Heavy use of unexplained medical jargon with a non-medical patient

Using unexplained technical terminology with a patient reduces comprehension and demonstrates poor lexical appropriateness, lowering the Speaking score.

Question 47: A social worker presents at a family meeting: 'Mrs. Tremblay lives alone and her daughter in Vancouver has expressed she cannot relocate. We're recommending a short-term placement in a transitional care unit while home care is arranged.' What is the proposed discharge plan?

Mrs. Tremblay will be temporarily placed in a transitional care unit while home care services are organized (Correct answer)
Mrs. Tremblay will be discharged directly home with no supports
Mrs. Tremblay will remain in the acute care hospital indefinitely
Mrs. Tremblay's daughter will move to Ontario to provide full-time care

Correct answer: Mrs. Tremblay will be temporarily placed in a transitional care unit while home care services are organized

The social worker proposes transitional (sub-acute) care placement as a bridge between hospital discharge and the establishment of appropriate home care services.

Question 48: A patient is described as 'diaphoretic.' Which assessment finding supports this?

Profuse sweating (Correct answer)
Dry, flaking skin
Cyanotic fingernails
Pupil dilation

Correct answer: Profuse sweating

Diaphoretic means the patient is experiencing excessive or profuse sweating, often associated with pain, fever, or cardiovascular events.

Question 49: A patient expresses a strong preference for a same-gender healthcare provider due to cultural or religious reasons. What should you do?

"We can’t guarantee that request."
"We will do our best to accommodate your preference." (Correct answer)
"You’ll have to accept whichever provider is available."
"Gender shouldn’t matter when receiving medical care."

Correct answer: "We will do our best to accommodate your preference."

Accommodating a patient's preference for a same-gender provider, especially when rooted in cultural or religious reasons, demonstrates respect for their beliefs and promotes comfort and trust. While not always possible, expressing a willingness to try shows patient-centered care and cultural sensitivity.

Question 50: During a CELBAN speaking scenario involving a patient from a different cultural background who declines physical contact during assessment, the nurse should:

Skip the physical assessment entirely to avoid discomfort.
Acknowledge the preference, explain the clinical necessity, and ask for the patient's consent before proceeding. (Correct answer)
Ask a nurse from the same background to perform all assessments.
Proceed with the assessment without acknowledging the patient's preferences.

Correct answer: Acknowledge the preference, explain the clinical necessity, and ask for the patient's consent before proceeding.

Culturally competent care requires acknowledging preferences, explaining clinical needs, and seeking informed consent before any contact.

Question 51: In the CELBAN Speaking section, which task type requires you to listen to a recorded scenario and then respond as if speaking directly to a patient or colleague?

Reading aloud task
Role-play task (Correct answer)
Monologue task
Picture description task

Correct answer: Role-play task

The role-play task in CELBAN Speaking presents a recorded prompt to which candidates respond as they would in a real clinical situation.

Question 52: During a CELBAN speaking role-play, a patient says they are confused about why they need to take a medication. What is the best opening response to address their concern?

Acknowledge their concern and offer to explain the medication's purpose clearly. (Correct answer)
Tell them the doctor ordered it and they must comply.
Advise them to ask the pharmacist when they get home.
Reassure them it is a routine medication and nothing to worry about.

Correct answer: Acknowledge their concern and offer to explain the medication's purpose clearly.

Acknowledging the patient's concern first demonstrates therapeutic communication, a key criterion in the CELBAN speaking assessment.

Question 53: During a CELBAN speaking task, a patient mentions they have been taking a herbal supplement and asks if it is safe with their prescribed blood thinner. The best nurse response is:

'Herbal supplements are natural, so they are definitely safe.'
'I'm glad you told me. Some herbal supplements can interact with blood thinners, so I'll note this and make sure the doctor or pharmacist reviews it with you.' (Correct answer)
'That is the pharmacist's job, not mine.'
'Stop taking the supplement immediately until we figure this out.'

Correct answer: 'I'm glad you told me. Some herbal supplements can interact with blood thinners, so I'll note this and make sure the doctor or pharmacist reviews it with you.'

Acknowledging the patient's disclosure, noting the potential for interactions, and escalating to the appropriate professional is the correct nursing response.

Question 54: A pharmacology reference passage states: 'Opioid analgesics act on mu, kappa, and delta receptors in the CNS. Common adverse effects include respiratory depression, constipation, urinary retention, nausea, and sedation. Tolerance develops to most effects except constipation.' A patient on long-term opioid therapy for cancer pain asks why they still need laxatives even though their pain control has stabilized. What is the BEST explanation?

Laxatives prevent the opioid from being reabsorbed in the bowel
Constipation is an opioid side effect that does not resolve with tolerance (Correct answer)
The cancer itself is causing the constipation, not the opioids
Laxatives help the opioid work faster and more effectively

Correct answer: Constipation is an opioid side effect that does not resolve with tolerance

Unlike most opioid side effects, tolerance to opioid-induced constipation does not develop, so bowel regimens remain necessary for the duration of opioid therapy.

Question 55: A laboratory report reads: 'Serum potassium 2.9 mEq/L (Reference: 3.5–5.0 mEq/L). Patient is on digoxin 0.125 mg daily.' Why is this lab result particularly significant for this patient?

Hypokalemia increases the risk of digoxin toxicity and cardiac arrhythmias (Correct answer)
Digoxin requires high potassium levels to be absorbed properly
Low potassium only causes muscle cramps and is not cardiac-related
Potassium must be above 5.0 mEq/L before digoxin can be given

Correct answer: Hypokalemia increases the risk of digoxin toxicity and cardiac arrhythmias

Hypokalemia potentiates digoxin toxicity by increasing cardiac sensitivity to the drug, raising the risk of life-threatening arrhythmias.

Question 56: During a CELBAN speaking task, you are asked to describe a patient's wound to a physician over the phone. Which characteristic should you describe FIRST using a systematic approach?

The type of dressing that has been applied previously
Whether the patient is on anticoagulants
Location, size, depth, color, and drainage of the wound (Correct answer)
The patient's emotional response to the wound

Correct answer: Location, size, depth, color, and drainage of the wound

A systematic wound description begins with observable clinical characteristics: location, dimensions, depth, color, and any drainage or odor.

Question 57: Globally, the coronavirus infection is beginning to spread in another form. The WHO called the mutation "Omicron," sticking to the Greek letters. Additionally, on November 9th, Botswana received the first report of this virus. Following the eighteen-day period, it was discovered in South Africa and labeled as a "virus of concern." Cases have since been recorded from Israel, Madagascar, Belgium, and Hong Kong. Epidemiologists have cautioned that this new strain may be very contagious and may be able to avoid the defenses provided by our present vaccinations. As a result, several nations have reinstated their restrictions on ravels. In spite of this, the Czech Republic, the UK, and Germany have all effectively reported new cases. Researchers have identified 50 genetic alterations in the DNA that affect the spikes that may make the virus more virulent, more transmissible, and potentially more resistant to vaccinations. These variations are being investigated by scientists in an effort to evaluate the potential risks that Omicron may offer. According to scientists, it can take a few weeks to ascertain how well our vaccinations work against Omicron. "When you've got a virus that's showing this degree of transmissibility, and you're having travel-related cases, it virtually invariably is getting to go everywhere [the world]," the chief medical advisor to the White House has issued a warning. How long might it take scientists to find out how dangerous Omicron is?

years
a few weeks (Correct answer)
months
hours

Correct answer: a few weeks

The passage states: 'it can take a few weeks to ascertain how well our vaccinations work against Omicron.' Months, years, and hours are all mentioned nowhere in the text — 'a few weeks' is the specific timeframe given by scientists.

Question 58: A patient chart shows: 'Last bowel movement 4 days ago, abdomen firm and distended, patient reports bloating.' Which intervention would the nurse expect to implement based on these chart findings?

Administer an antiemetic
Restrict oral fluid intake
Initiate bowel care protocol, including laxative or enema as ordered (Correct answer)
Place a nasogastric tube

Correct answer: Initiate bowel care protocol, including laxative or enema as ordered

Four days without a bowel movement, abdominal distension, and firmness indicate constipation requiring bowel care interventions such as stool softeners, laxatives, or enemas.

Question 59: A nursing note states: 'Pt. A&O x 3.' What does this assessment finding indicate?

The patient has been assessed three separate times today
The patient is alert and has three active medical diagnoses
The patient is ambulatory and oxygen-dependent for three hours
The patient is alert and oriented to person, place, and time (Correct answer)

Correct answer: The patient is alert and oriented to person, place, and time

A&O x 3 means alert and oriented to three domains: person (who they are), place (where they are), and time (date/day).

Question 60: During a care conference, a family member states: 'We want everything done — we can't just let him go.' The patient previously told a nurse he did not want aggressive interventions. What should the nurse do?

Advocate for the patient's expressed wishes and raise the need to clarify goals of care (Correct answer)
Follow the family's wishes since they are the legal decision-makers
Defer entirely to the attending physician without contributing to the discussion
Ask the family to leave the conference so the team can decide independently

Correct answer: Advocate for the patient's expressed wishes and raise the need to clarify goals of care

Nurses are obligated to advocate for the patient's expressed wishes and facilitate a goals-of-care conversation that honors patient autonomy.

Question 61: During a CELBAN speaking scenario, you must explain the purpose of a blood pressure cuff to a patient who has never used one before. The best approach is to use:

A technical explanation using advanced cardiovascular terminology.
Simple language and a brief analogy, such as 'This cuff gently squeezes your arm to measure the force of your blood flow.' (Correct answer)
Medical abbreviations like 'BP cuff for recording systolic and diastolic readings.'
Avoid any explanation and just proceed with the measurement.

Correct answer: Simple language and a brief analogy, such as 'This cuff gently squeezes your arm to measure the force of your blood flow.'

Simple language with a relatable analogy makes medical equipment less intimidating and supports patient health literacy.

Question 62: During a nursing handover the outgoing nurse says: 'He's a full code, but the family meeting this afternoon may change that — family has expressed concerns about quality of life.' What should the incoming nurse prioritize?

Disregarding the family's concerns as they cannot legally change code status
Immediately changing the patient's code status in the chart without the family meeting
Being aware that current status is full resuscitation but code status may be revised after the afternoon family meeting (Correct answer)
Informing the patient his family wants to withdraw care

Correct answer: Being aware that current status is full resuscitation but code status may be revised after the afternoon family meeting

The handover conveys that the patient is currently full code but that a family meeting may lead to a code status change, so the incoming nurse must remain updated.

Question 63: A nurse reads the following progress note for a post-operative patient: 'Day 2 post-op R TKR. Pt ambulated 10m with 2x assist. Incision C/D/I, no erythema or purulent drainage noted. States pain managed with PO analgesia. Voiding qs. A/O x 3.' Which of the following indicates the patient is progressing as expected?

The presence of erythema and purulent drainage.
The report of unmanaged pain despite medication.
The clean, dry, and intact incision site. (Correct answer)
The need for two people to assist with ambulation.

Correct answer: The clean, dry, and intact incision site.

The note 'Incision C/D/I' stands for Clean, Dry, and Intact. The absence of 'erythema' (redness) or 'purulent drainage' (pus) are positive signs that the surgical wound from the Right Total Knee Replacement (R TKR) is healing properly without signs of infection. Ambulation with assistance is expected on day 2 post-op, and pain managed with oral ('PO') medication is a good sign.

Question 64: A chart shows the following order: 'Ambulate TID with assistance, fall precautions in place.' What does TID mean?

Twice daily
Three times daily (Correct answer)
As tolerated
Every other day

Correct answer: Three times daily

TID is the Latin abbreviation for 'ter in die,' meaning three times per day.

Question 65: A chart order reads: 'Discontinue IV access if tolerating PO fluids.' When should the nurse remove the IV?

Once the patient can drink and swallow fluids without difficulty (Correct answer)
As soon as the IV fluids run out
After 24 hours have passed since the last IV dose
When the patient requests oral fluids

Correct answer: Once the patient can drink and swallow fluids without difficulty

'Tolerating PO fluids' means the patient can drink and swallow oral fluids without nausea, vomiting, or difficulty.

Question 66: In a CELBAN speaking scenario, a patient reports that the medication you just administered is causing a burning sensation in their arm. What is your immediate verbal response?

'The doctor ordered this medication so it must be fine.'
'That's normal, don't worry about it.'
'I'll stop the infusion right now and assess your arm. Can you show me exactly where you feel the burning?' (Correct answer)
'Try to relax; it will pass in a few minutes.'

Correct answer: 'I'll stop the infusion right now and assess your arm. Can you show me exactly where you feel the burning?'

Stopping the infusion immediately and assessing the site is the safe, patient-centered response to a potential infiltration or phlebitis complaint.

Question 67: A patient's family member tells the nurse over the phone: 'She mentioned her chest feels tight and she's sweating a lot — she said it started about an hour ago. She didn't want me to call but I was worried.' What is the most clinically significant information in this message?

The family member is requesting a callback in the morning
The family member called without the patient's permission
The patient is non-compliant with her discharge instructions
The patient has had chest tightness and diaphoresis for approximately one hour, which could indicate a cardiac event (Correct answer)

Correct answer: The patient has had chest tightness and diaphoresis for approximately one hour, which could indicate a cardiac event

Chest tightness and diaphoresis lasting an hour are classic warning signs of acute myocardial infarction and require immediate clinical assessment.

Question 68: Globally, the coronavirus infection is beginning to spread in another form. The WHO called the mutation "Omicon," sticking to the Greek letters. Additionally, on November 9th, Botswana received the first report of this virus. Following the eighteen-day period, it was discovered in South Africa and labeled as a "virus of concern." Cases have since been recorded from Israel, Madagascar, Belgium, and Hong Kong. Epidemiologists have cautioned that this new strain may be very contagious and may be able to avoid the defenses provided by our present vaccinations. As a result, several nations have reinstated their restrictions on ravels. In spite of this, the Czech Republic, the UK, and Germany have all effectively reported new cases. Researchers have identified 50 genetic alterations in the DNA that affect the spikes that may make the virus more virulent, more transmissible, and potentially more resistant to vaccinations. These variations are being investigated by scientists in an effort to evaluate the potential risks that Omicron may offer. According to scientists, it can take a few weeks to ascertain how well our vaccinations work against Omicron. "When you've got a virus that's showing this degree of transmissibility, and you're having travel-related cases, it virtually invariably is getting to go everywhere [the world]," the chief medical advisor to the White House has issued a warning. Who named the new variant Omicron?

South Korea's government
The Geek Alphabet Association
The WHO (Correct answer)
South Africa's government

Correct answer: The WHO

The passage states explicitly: 'The WHO called the mutation "Omicron," sticking to the Greek letters.' No other organization is credited with naming the variant. The other options — a Greek Alphabet Association (fictional), South Korea, or South Africa — are not mentioned in this role.

Question 69: You hear a pediatric patient tell their parent: 'The nurse gave me a needle but I didn't cry because she told me to squeeze your hand.' What does this dialogue reveal about effective nursing technique?

Children should not be warned before painful procedures to avoid anticipatory anxiety
The patient's coping was entirely self-directed without nursing input
Parental presence during procedures is discouraged in hospital settings
Distraction and comfort strategies reduce procedural distress in pediatric patients (Correct answer)

Correct answer: Distraction and comfort strategies reduce procedural distress in pediatric patients

The nurse's use of a coping instruction (hand-squeezing as distraction) demonstrates evidence-based non-pharmacological pain management in pediatrics.

Question 70: A clinical article states: 'Pressure injuries are staged I through IV, with unstageable wounds also recognized. Stage II involves partial-thickness skin loss with exposed dermis, while Stage III involves full-thickness skin loss without exposed fascia.' A patient's wound shows subcutaneous fat visible but no bone, tendon, or muscle. Which stage is this?

Unstageable
Stage IV
Stage III (Correct answer)
Stage II

Correct answer: Stage III

Visible subcutaneous fat with full-thickness skin loss but no exposed bone, tendon, or muscle is consistent with Stage III pressure injury.

Question 71: A hospital policy on medication errors reads: 'Any medication error, regardless of patient harm, must be reported through the incident reporting system. Near-miss events — errors caught before reaching the patient — must also be reported. Reporting is non-punitive and used for quality improvement.' A nurse catches a colleague about to give a double dose of morphine and corrects it before administration. What should the nurse do?

Speak with the charge nurse verbally and let them decide whether to report
File a near-miss report in the incident system per policy (Correct answer)
Say nothing to avoid getting the colleague in trouble since no harm occurred
Report it only if the patient had received the double dose

Correct answer: File a near-miss report in the incident system per policy

The policy explicitly requires near-miss events to be reported through the incident system; the non-punitive culture supports reporting to improve safety.

Question 72: A nurse receives a phone call from a physician requesting a patient update. Which opening response is most appropriate?

Hello, who is this?
This is Nurse Patel on 4 West. How can I help you? (Correct answer)
The patient is fine, don't worry.
Hold on, I need to find the chart.

Correct answer: This is Nurse Patel on 4 West. How can I help you?

Identifying yourself with your name and unit establishes professionalism and helps the caller confirm they have reached the right person.

Question 73: You hear a pharmacist say, "This medication may cause drowsiness. Avoid operating machinery." What should the patient do?

Take extra doses to stay awake.
Avoid taking the medication.
Operate machinery as usual.
Be cautious and avoid using machinery. (Correct answer)

Correct answer: Be cautious and avoid using machinery.

The warning "This medication may cause drowsiness. Avoid operating machinery" directly advises against activities that require alertness and coordination. Drowsiness can impair judgment and reaction time, making it unsafe to operate machinery. Therefore, the patient should be cautious and refrain from such activities.

Question 74: A chart progress note reads: 'Crackles auscultated bilaterally at lung bases, O2 sat 91% on 2L NC.' What should the nurse do first?

Encourage the patient to cough and deep breathe
Increase oxygen flow rate and reassess oxygen saturation (Correct answer)
Document findings and reassess in one hour
Notify the physician of worsening respiratory status

Correct answer: Increase oxygen flow rate and reassess oxygen saturation

An O2 saturation of 91% is below the acceptable threshold of 95%; increasing the oxygen delivery and reassessing is the immediate nursing action.

Question 75: A charge nurse overhears a new nurse tell a patient: 'Your surgery is tomorrow morning, so you can't eat after midnight.' The patient's surgery is actually scheduled for the afternoon. What should the charge nurse do first?

Immediately clarify the fasting instructions with the patient to prevent unnecessary prolonged fasting (Correct answer)
Ask the patient to confirm the time with the surgeon directly
Document the communication error in the incident report first
Correct the new nurse privately later during the shift

Correct answer: Immediately clarify the fasting instructions with the patient to prevent unnecessary prolonged fasting

Prolonged unnecessary fasting can cause patient discomfort and dehydration; immediate correction of the instruction to the patient is the priority.

Question 76: Which sentence uses 'adverse' correctly?

The patient experienced an adverse reaction to the antibiotic. (Correct answer)
The doctor was adverse to performing the procedure.
The nurse had an adverse opinion about the policy.
The weather was adverse to the patient's schedule.

Correct answer: The patient experienced an adverse reaction to the antibiotic.

'Adverse reaction' is the standard clinical term for a harmful response to a medication or treatment.

Question 77: As an illustration: Hello, my name is Aline, and I will be your nurse from 8 a.m. until 5 p.m. today. During my shift, just let me know if you have any concerns. Simply press #8 on your bedside phone if you need assistance.

Revalidation phrase
Level setting of expectations with empathy
Set appropriate expectations (Correct answer)
Better probing question

Correct answer: Set appropriate expectations

The nurse is communicating specific boundaries — her name, her working hours, and exactly how to reach her — which is the definition of setting appropriate expectations. 'Level setting of expectations with empathy' would also acknowledge difficulty or emotion, and a revalidation phrase would confirm understanding, neither of which is happening here.

Question 78: When is the LEAST appropriate time to provide complex discharge instructions?

When the patient is in severe pain or heavily sedated (Correct answer)
The morning before discharge
One to two days prior to discharge
When a support person is present

Correct answer: When the patient is in severe pain or heavily sedated

Pain and sedation impair cognition and memory, making it impossible for the patient to absorb and retain complex information.

Question 79: A statement of urgency

You can also ask probing questions that will help you obtain more information such as:
"In this case, time is of the essence. I am going to speak with Dr. Brown or my Nurse Supervisor to help me expedite this issue." (Correct answer)
Once you have a good understanding of the patient's needs, let them know when they can expect to have their symptoms resolved. This can be as simple as saying:
Let the patient know that you are aware of the urgency/complexity of the issue. It is often reassuring to the patients when you communicate an understanding of the importance of their issue/situation. When it is an urgent matter, reassure them that you know it is. You can say:

Correct answer: "In this case, time is of the essence. I am going to speak with Dr. Brown or my Nurse Supervisor to help me expedite this issue."

This statement is a statement of urgency because it both acknowledges that time is critical and states a clear plan of action — escalating to Dr. Brown or the Nurse Supervisor to expedite the issue. The other options only express empathy, ask probing questions, or set resolution expectations without combining urgency with a concrete next step.

Question 80: When asking about tobacco use, a patient reports quitting five years ago. How should this be documented?

Former smoker with cessation date noted (Correct answer)
Tobacco use unknown
Non-smoker
Never smoker

Correct answer: Former smoker with cessation date noted

A patient who formerly smoked but has quit should be documented as a former smoker, including the quit date and, ideally, pack-year history, as past tobacco use remains clinically relevant.

Question 81: A policy on restraint use reads: 'Physical restraints may only be applied when less restrictive alternatives have been attempted and failed, a physician order has been obtained, and patient safety cannot otherwise be ensured. Reassessment must occur every 2 hours.' A nurse applies a wrist restraint without a physician order because the patient keeps pulling at their IV line. What should happen next?

The restraint is acceptable since patient safety was at risk
The restraint can remain for up to 8 hours before an order is needed
The nurse must obtain a physician order immediately and document the emergent application (Correct answer)
The family must be notified before any order is sought

Correct answer: The nurse must obtain a physician order immediately and document the emergent application

Even in emergent situations, a physician order must be obtained as soon as possible after applying a restraint, as required by policy and legislation.

Question 82: A CELBAN speaking role-play involves a patient who is crying and refuses to talk. What is the first action the nurse should take?

Sit quietly beside the patient and offer a compassionate presence without forcing conversation. (Correct answer)
Leave the room and return in 10 minutes.
Ask a series of yes/no questions to gather assessment data immediately.
Call the doctor right away to report the patient is uncooperative.

Correct answer: Sit quietly beside the patient and offer a compassionate presence without forcing conversation.

Offering a calm, compassionate presence without pressure allows the patient to feel safe and supported before they are ready to communicate.

Question 83: A nurse reviews a patient's fluid balance chart showing: 'I&O: 1,850 mL / 650 mL.' What should the nurse report to the physician?

The patient has a significant positive fluid balance suggesting fluid retention (Correct answer)
The patient is dehydrated and needs less fluid intake
The patient is adequately hydrated
The output is higher than intake, indicating normal kidney function

Correct answer: The patient has a significant positive fluid balance suggesting fluid retention

A difference of 1,200 mL between intake (1,850 mL) and output (650 mL) represents a significant positive fluid balance that may indicate fluid retention.

Question 84: When giving discharge instructions during a CELBAN speaking task, what is the most effective technique to verify patient understanding?

Ask the patient to sign a consent form.
Hand the patient a brochure with written instructions.
Use the teach-back method by asking the patient to repeat the instructions in their own words. (Correct answer)
Tell the patient to call if they have questions later.

Correct answer: Use the teach-back method by asking the patient to repeat the instructions in their own words.

The teach-back method is widely recognized as the most reliable way to confirm patient comprehension during discharge education.

Question 85: A nurse hears a patient tell an occupational therapist: 'I used to cook every day — it was my whole life. Now I can't even open a jar.' The patient's voice cracks. What does this exchange reveal?

The patient is being hyperbolic about their disability for sympathy
The patient is experiencing grief over a loss of functional independence and identity, requiring emotional acknowledgment (Correct answer)
The patient requires a stronger grip-strength rehabilitation program
Occupational therapy goals should be revised to exclude cooking tasks

Correct answer: The patient is experiencing grief over a loss of functional independence and identity, requiring emotional acknowledgment

Loss of a meaningful activity signals grief and a threat to identity, which should be acknowledged therapeutically before focusing on skill rebuilding.

Question 86: A patient in a CELBAN speaking role-play asks: 'What happens if I don't take my blood thinners?' The best nurse response is:

'That is a very risky question to even ask.'
'You could develop a dangerous blood clot, which might block blood flow to your heart or brain. It's important we understand your concerns about the medication.' (Correct answer)
'You'll probably be fine; lots of people stop taking medications.'
'That's not really my area — ask your doctor.'

Correct answer: 'You could develop a dangerous blood clot, which might block blood flow to your heart or brain. It's important we understand your concerns about the medication.'

The nurse should clearly explain the clinical risks of non-adherence and explore the patient's underlying concerns in a non-judgmental way.

Question 87: A nurse is asked by a patient to keep a conversation about substance use secret from other staff. What is the appropriate response?

Explain the limits of confidentiality and that information affecting care or safety must be shared with the team (Correct answer)
Refuse to discuss the topic at all
Agree to confidentiality to gain the patient's trust
Share the information only with nursing staff, not physicians

Correct answer: Explain the limits of confidentiality and that information affecting care or safety must be shared with the team

Nurses must explain that confidentiality has limits when patient safety or care decisions are affected.

Question 88: "This is a bit complicated. I should be able to let you know how we can work on this _______."

Level setting of expectations with empathy (Correct answer)
Revalidation phrase
Better probing question
Set appropriate expectations

Correct answer: Level setting of expectations with empathy

The phrase acknowledges the situation is complicated (showing empathy and honesty) while committing to a future update with a time placeholder, which is the hallmark of level setting expectations with empathy. Plain 'set appropriate expectations' lacks the empathetic tone, and a revalidation phrase would confirm what was heard rather than project forward.

Question 89: A nurse listens to a patient explain their pain to a resident physician: 'It's not really pain — it's more like pressure, right here, and it goes up into my jaw.' The resident documents 'patient denies pain.' What is the nursing concern?

The nurse should not intervene in physician documentation
The resident may have missed a potential cardiac symptom by interpreting 'not pain' too literally (Correct answer)
The resident correctly documented the patient's exact words
The patient needs to be coached to use the word 'pain' for accurate charting

Correct answer: The resident may have missed a potential cardiac symptom by interpreting 'not pain' too literally

Pressure radiating to the jaw is a classic anginal equivalent; the nurse must alert the team that the symptom requires cardiac evaluation regardless of the patient's word choice.

Question 90: When communicating a pain assessment to a physician over the phone during a CELBAN speaking task, which structured communication tool is most appropriate?

SOAP note format
ADPIE
SBAR (Situation, Background, Assessment, Recommendation) (Correct answer)
WILDA mnemonic

Correct answer: SBAR (Situation, Background, Assessment, Recommendation)

SBAR is the standard structured communication tool used for verbal reporting to physicians in Canadian healthcare settings.

Question 91: Globally, the coronavirus infection is beginning to spread in another form. The WHO called the mutation "Omicron," sticking to the Greek letters. Additionally, on November 9th, Botswana received the first report of this virus. Following the eighteen-day period, it was discovered in South Africa and labeled as a "virus of concern." Cases have since been recorded from Israel, Madagascar, Belgium, and Hong Kong. Epidemiologists have cautioned that this new strain may be very contagious and may be able to avoid the defenses provided by our present vaccinations. As a result, several nations have reinstated their restrictions on ravels. In spite of this, the Czech Republic, the UK, and Germany have all effectively reported new cases. Researchers have identified 50 genetic alterations in the DNA that affect the spikes that may make the virus more virulent, more transmissible, and potentially more resistant to vaccinations. These variations are being investigated by scientists in an effort to evaluate the potential risks that Omicron may offer. According to scientists, it can take a few weeks to ascertain how well our vaccinations work against Omicron. "When you've got a virus that's showing this degree of transmissibility, and you're having travel-related cases, it virtually invariably is getting to go everywhere [the world]," the chief medical advisor to the White House has issued a warning. Which member of the White House staff commented on Omicron?

the senior advisor to the President
the special advisor to vaccines
the chief medical adviser (Correct answer)
the chief of staff

Correct answer: the chief medical adviser

The final sentence of the passage attributes the quoted warning to 'the chief medical advisor to the White House.' The chief of staff, senior advisor to the President, and special advisor to vaccines are all plausible-sounding titles but are not mentioned in the text.

Question 92: When taking an obstetric history, a patient states she is G4P2. What does this indicate?

Four deliveries, two of which were vaginal
Four prenatal visits, two at term
Two pregnancies, four living children
Four pregnancies, two of which ended in delivery (Correct answer)

Correct answer: Four pregnancies, two of which ended in delivery

G4P2 means gravida 4 (four total pregnancies) and para 2 (two deliveries beyond 20 weeks gestation), which implies two pregnancies ended in abortion or miscarriage.

Question 93: When taking a patient's health history, which of the following represents subjective data?

A rash with raised red papules is noted on the patient's forearms.
The patient grimaces when their abdomen is palpated.
The patient's blood pressure reading is 145/92 mmHg.
The patient states, "I've had a sharp headache behind my eyes for two days." (Correct answer)

Correct answer: The patient states, "I've had a sharp headache behind my eyes for two days."

Subjective data is information reported by the patient from their own perspective, such as their feelings, perceptions, and symptoms. The other options are objective findings that the nurse can see, measure, or observe.

Question 94: During a shift-change report, the outgoing nurse describes a patient as 'a bit anxious' and reports that the patient's family 'has been calling frequently.' What is the primary purpose of conveying this information to the incoming nurse?

To complain about the patient's family.
To indicate that the patient's physical condition has worsened.
To suggest the patient is ready for discharge.
To prepare the nurse for the patient's psychosocial and emotional needs. (Correct answer)

Correct answer: To prepare the nurse for the patient's psychosocial and emotional needs.

Reporting on a patient's anxiety and frequent family calls provides important context about the patient's emotional state and family dynamics. This allows the incoming nurse to be prepared to offer psychosocial support, manage family communication, and provide holistic care beyond just the physical symptoms.

Question 95: When documenting a patient's report of pain, a nurse should record:

'Patient is in severe pain and appears dramatic'
'Patient states pain is 8/10, describes it as stabbing in the right lower abdomen' (Correct answer)
'Patient complaining of abdominal pain — likely GI issue'
'Pain noted; analgesic administered'

Correct answer: 'Patient states pain is 8/10, describes it as stabbing in the right lower abdomen'

Objective documentation uses the patient's own words and specific measurable details without interpretation or bias.

Question 96: A CELBAN speaking task asks you to explain NPO (nothing by mouth) instructions to a patient before a morning procedure. Which explanation is most appropriate?

'The doctor says no eating. Just follow the rules.'
'You are NPO from midnight — no food or drink, including water.'
'Don't eat or drink anything, including water, after midnight. This keeps your stomach empty so the anesthesia is safer.' (Correct answer)
'You can have clear fluids up until your procedure begins.'

Correct answer: 'Don't eat or drink anything, including water, after midnight. This keeps your stomach empty so the anesthesia is safer.'

Giving the instruction in plain language and briefly explaining the reason increases patient understanding and compliance.

Question 97: A nurse observes that a patient's urine output has dropped to less than 30 mL per hour over the past two hours. What is the most appropriate response?

Assume the urinary catheter is blocked and change it without assessment
Assess for other signs of deterioration and notify the physician promptly (Correct answer)
Document the finding and reassess in four hours
Increase the patient's oral fluid intake independently

Correct answer: Assess for other signs of deterioration and notify the physician promptly

Oliguria may indicate renal compromise or hemodynamic instability and requires prompt clinical assessment and physician notification.

Question 98: Everyone knows that getting into bed early has a significant impact on our fitness. Researchers claim to have found the best time of day to go to bed. British researchers. The ideal bedtime, according to Biobank, is between 10 and 11 p.m. People who sleep between these hours are said to be less likely to develop heart disease. The researchers collected information on the sleeping habits of eighty thousand individuals six years ago. For seven days, the volunteers were required to wear a unique watch that allowed the researchers to record their sleeping and waking hours. The volunteers' level of fitness was then observed by the investigators. Approximately 3,000 volunteers experienced cardiac issues. They either went to bed before or after the "healthy" 10 o'clock or 11 o'clock period. Dr. David Plans, one of the study's authors, made observations about the effects of sleep patterns on heart health in his research. He said, "Although our study does not allow us to conclude on causality, the results suggest that early or late bedtimes may disrupt the body clock, with [negative] outcomes for cardiovascular fitness." However, he added, "Changing into is able to reduce the probability of seeing morning light, which resets the body clock." If our body clock isn't always reset correctly, we run the risk of developing cardiovascular disease. How many volunteers were part of the research?

28,000
88,000
80,000 (Correct answer)
86,000

Correct answer: 80,000

The passage states: 'The researchers collected information on the sleeping habits of eighty thousand individuals,' which equals 80,000. The other numbers (88,000, 86,000, 28,000) are close numerical distractors that do not appear in the text.

Question 99: A nurse overhears a patient tell their family member: 'The doctor said something about my potassium being low, but I don't really understand what that means for me.' What is the patient expressing?

Satisfaction with the physician's explanation
Confusion about the clinical significance of a lab result (Correct answer)
A request to speak with a dietitian
Concern that the doctor made a mistake

Correct answer: Confusion about the clinical significance of a lab result

The patient is indicating they received information but do not understand its implications, signaling a need for further education.

Question 100: When a patient's concept of illness causation is rooted in spiritual beliefs (e.g., illness as divine punishment), the culturally competent nurse should:

Explore the patient's belief system and incorporate spiritual support into the care plan when appropriate (Correct answer)
Correct the patient's beliefs with evidence-based medical explanations
Inform the patient that spiritual beliefs have no place in medical care
Avoid engaging with spiritual topics as they are outside nursing scope

Correct answer: Explore the patient's belief system and incorporate spiritual support into the care plan when appropriate

Acknowledging and incorporating a patient's spiritual beliefs into care planning promotes holistic, culturally respectful nursing practice.

Canadian English Language Benchmark Assessment for Nurses (CELBAN)

CELBAN assesses the English language proficiency of internationally educated nurses (IENs) who wish to practice nursing in Canada.

100

Questions

180 min

Time Limit

70%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds